Health care reform is the topic of discussion and media is giving lot of air time to this issue. Many of us have seen spirited town halls meetings, heated debates on television channel, and business channels focusing on economic aspects. Medical professionals has its own views on how to reduce cost, pharmaceutical companies have their own agendas, insurance companies are not bogging down, rich don’t want to pay for poor and illegal immigrants, companies are looking for ways to reduce their cost, and finally, our government wants to pay but has no clue where will it pay from (printing dollars?).
All this makes me tend to believe nothing is going to come out of this debate. There are few things that really bug me (1) There is notion that similar to Walmart-ization of medicines to four dollars, if there is Health-mart, it will reduce cost; (2) There is a lot of focus on debates between business community and politicians, while healthcare professional including doctors are being left behind in this debate; and (3) This concept of medical tourism – where you can go to some other country like Mexico or India and get cheap medical procedures.
First, the notion of Walmart-ization of health care (a.k.a. Health-Mart) will resolve the problem of high cost. Folks purporting this concept fail to understand that the concept of Walmart works for run off the mill types of products which does not have high reliability associated with it. It is simply cost arbitrage based on sourcing or based on currency difference. Even Walmart sells medicines that are in hundreds of dollars (and not four dollars as being marketed). There is no concept of development, quality, and reliability. Would you buy a cold medication or pain medication manufactured in China or Bangladesh? Would you be comfortable sending your sick parent or kid into MRI or CAT Scanner manufactured in any emerging country? In the environment of WalMart, there will never be a new drug formulation or invention. There can be many more similar examples. Just because a particular concept works in one domain, it does not mean one can just transplant a same approach everywhere. (NOTE – I am not attempting to deride any emerging country. I am just being pragmatic)
Second, health care professional including doctors are being pushed behind in this debate. Medical community is saying, don’t let insurers’ dictate us what we should do, instead do something to change the culture of lawsuit claims. You go to the doctor for cold and fever, and you get handed the slue of medical test. In many cases, it is not required, but doctors are forced to do it to cover their bases from possible future claims. Healthcare professionals saying cost can be reduced by 30% by proper electronic administration. Here also there is a debate about privacy issues. Are we going to listen to them? Probably not, because its business interest driven.
Third, if countries like Mexico or India can provide cheap surgery, why can’t we in US replicate that model? I find this argument completely out of whack. It’s cheap because of the currency difference. It is not cheap on purchase power parity. The kind of medical attention US patient gets is in many cases elitist in those countries. It’s the power of dollar that makes it appear cheap.
Unfortunately, its human nature to think grass is always greener on other side. We never appreciate what we have, instead we envy others. I believe, in relative terms, US health care sector provide a best in class, high quality health care. It’s all about cost associated with it.
Like in any other sector, all it requires is control in greed of insurance companies. We need to control the business practices of insurance companies. In my opinion, insurance companies for their business interest have screwed the whole health care sector.
What are your thoughts?